Apex Gold
Starting at
$733
/month before subsidy
Apex Gold is a 2027 Gold EPO health insurance plan from Ambetter of Tennessee, sold on the ACA Marketplace in Tennessee under plan ID 70111TN0110021. The monthly premium starts at $733 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $1,500 ($3,000 for a family), and the individual out-of-pocket maximum is $8,350 ($16,700 for a family). After the deductible, coinsurance is 25% for covered in-network care. The plan is not HSA-eligible.
- Plan ID
- 70111TN0110021
- Plan year
- 2027
- State
- Tennessee
- Metal level
- Gold
- Plan type
- EPO
- HSA-eligible
- No
Individual Deductible
$1,500
Family: $3,000
Out-of-Pocket Max
$8,350
Family: $16,700
Coinsurance
25%
You pay after deductible
Network Type
EPO
TNN001
Medical Services
Prescription Drugs
- Medical care
- Member experience
- Plan administration
How well doctors manage and coordinate care
Member-survey satisfaction with the plan
Customer service, billing, and access to information
Having a baby
Normal delivery
$3,760
your estimated cost
- Deductible
- $1,500
- Copays
- $400
- Coinsurance
- $1,800
Managing type 2 diabetes
A year of routine care
$1,820
your estimated cost
- Deductible
- $800
- Copays
- $1,000
- Coinsurance
- $0
A simple fracture
ER visit + follow-up
$1,900
your estimated cost
- Deductible
- $1,500
- Copays
- $200
- Coinsurance
- $200
Enter your ZIP code first to search nearby doctors.
This Gold EPO plan is designed for people who use healthcare frequently and want predictable costs when they visit the doctor.
Consider this plan if you:
- Have ongoing health conditions requiring regular care
- Take multiple prescription medications
- Prefer lower costs at the time of service
- Want peace of mind with comprehensive coverage
This summary is generated based on plan attributes for educational purposes only.
If you max out this year
$1,429/month
Annual Premium
$8,796
OOP Maximum
$8,350
💡 What this means:
With a $1,500 deductible, you pay 100% of costs until you've spent that much. After that, you pay 25% (coinsurance) until you hit $8,350 total. Then insurance covers everything else for the year.
More plans from Ambetter of Tennessee in Tennessee
- Elite Bronzefrom $628/mo
- Elite Bronze + Vision + Adult Dentalfrom $643/mo
- Everyday Bronzefrom $563/mo
- Everyday Bronze + Vision + Adult Dentalfrom $577/mo
- Signature Expanded Bronzefrom $555/mo
- Signature Expanded Bronze + Vision + Adult Dentalfrom $568/mo
- Enhanced Diabetes Care Silver $0 Rx Optionsfrom $731/mo
- Enhanced Diabetes Care Silver $0 Rx Options + Vision + Adult Dentalfrom $748/mo
Frequently asked questions about Apex Gold
How much does Apex Gold cost per month?
Apex Gold from Ambetter of Tennessee starts at $733 per month before any subsidy in Tennessee. Most Marketplace enrollees qualify for a premium tax credit that lowers what they actually pay — estimate your subsidy to see your net premium.
What is the deductible for Apex Gold?
The individual medical deductible is $1,500, and the family deductible is $3,000. You pay for covered care out of pocket until you meet the deductible, after which the plan shares costs with you.
What is the out-of-pocket maximum for Apex Gold?
The most you would pay in a year for covered in-network care is $8,350 for an individual and $16,700 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.
Is Apex Gold HSA-eligible?
No. Apex Gold is not classified as an HSA-eligible high-deductible health plan, so it cannot be paired with a Health Savings Account.
What type of network does Apex Gold use?
Apex Gold is a EPO plan. EPO plans cover in-network care only (except emergencies) and usually do not require referrals to see specialists.
Understand what you'd actually pay
- 2026 Federal Poverty Level (FPL) chart
The income table behind subsidy and Medicaid eligibility
- How ACA subsidies work
Premium tax credits and who qualifies
- The 2026 subsidy cliff
Why income near 400% FPL matters again this year
- The SLCSP benchmark
The Silver plan that sets your subsidy and Form 1095-A
Important Notice
Plan details and costs shown are estimates for educational purposes only. Actual costs, coverage, and availability may vary. Always verify plan details and enroll through official channels at HealthCare.gov or your state marketplace.